JGen (6th-12th grade) Registration

Parent/Guardian Information

Parent Name

Parent Email

This address will receive a confirmation email

Address

Parent Cell Phone

Home Phone

Student #1 Information

Student Name

Birthdate

Grade

Cell Phone

Student #2 Information

Student Name

Birthdate

Cell Phone

Grade

Student #3 Information

Student Name

Birthdate

Cell Phone

Grade

Emergency Contact Information

Emergency Contact Name

Cell Phone

Medical and Photo Release

I acknowledge that in the event of an emergency in which my child is in need of immediate hospitalization, medical attention or surgery, and after reasonable efforts have been made to contact me or my spouse and we cannot be located for the purpose of consenting thereto, consent for the emergency attention may be given to any person standing in loco parentis to my child. I understand that any expenses incurred in necessary emergency or other medical treatment will be borne solely by the child’s medical coverage and/or family. For severe allergies and medical conditions, please provide a separate sheet of paper with special instructions to NewDay leadership. I also give permission for NewDay Church to use photos/videos of my child in promotions.

I Aknowledge

Comments:

JGen (6th-12th grade) Registration

Description

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